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Introducing the Pitch Day Finalists: MD 360

Oct 4, 2013, 9:00 AM, Posted by Pioneer Blog Team

Tara Bishop Tara Bishop, MD, MPH

Tara Bishop, MD, MPH, wants to offer 360-degree reviews of doctors and other healthcare providers that incorporate objective measures of quality as well as peer and patient ratings. She was one of eight finalists we invited to pitch us their ideas live and in person at the first-ever Pioneer Pitch Day. Read Dr. Bishop's 1,000-character proposal below, and join the discussion on Twitter at #pioneerpitch.

Dr. Bishop is a practicing physician as well as the director of quality improvement operations for the Department of Medicine at Weill Cornell Medical College. You can connect with her on Twitter at @tarabishopmd.

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Moving Forward with OpenNotes

Aug 14, 2013, 8:00 AM, Posted by Steve Downs

Open Notes_20120530_00476

As Beth Israel Deaconess Medical Center (BIDMC) begins its institutional rollout of OpenNotes, it's becoming clear that we've moved into a new phase of the diffusion of this innovation. I've been in discussions with OpenNotes co-directors Tom Delbanco, MD and Jan Walker, RN, MBA about the idea of opening up physician notes to patients since 2008, when it was a bold, controversial idea that needed to be tested. The landmark study that Tom, Jan and their colleagues conducted over 2011-2012 and published last fall made it quite clear that the idea had merit: overwhelming percentages of patients found it helped them better understand their conditions, feel in more control of their health and even take their medicines more regularly. 99 percent of patients in the study wanted to continue with the practice. As for physicians, their fears went largely unrealized. It simply wasn't a big deal.

Recently we've seen more leading institutions climb on board with the practice of sharing medical notes: the VA is adopting OpenNotes, as is Group Health Cooperative; Geisinger, one of the original study sites, is expanding the practice throughout much of its system; the Cleveland Clinic announced its intention to share visit notes; and you can now read your doctor's notes at the Mayo Clinic. More will undoubtedly follow in the months and years ahead. As we move into the implementation phase at these and other institutions, the questions will shift from whether the idea is good to more practical inquiries around how well it fits certain specialties (like psychiatry) or departments; whether there are patterns in the types of patients (or physicians) that flourish under this approach; and how to manage the cultural changes that OpenNotes implies.

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User-Centric Innovation

Jul 10, 2013, 8:00 AM, Posted by Christine Nieves

Christine Nieves / RWJF Program Associate Christine Nieves

Determined to increase my productivity and keep my desk free from clutter, I recently read an excellent book that several friends recommended to me called Getting Things Done: The Art of Stress-Free Productivity by David Allen. We at Pioneer talk quite a bit about what it takes to change behavior – what kinds of innovations can we support that will help more people embrace healthy habits? Implementing this book’s recommendations reminded me just how stressful change can be – even change that’s designed to reduce stress! And it got me thinking about how important it is to base any innovation on a real understanding of the people it effects.

I recently spent the day at the MedStar Institute for Innovation -– at Pioneer, we’re always interested in learning more about other units within large organizations that are focused on innovation (and we love to play host, too). Anyway, the folks at MedStar spoke quite a bit about human factors engineering. If you aren’t familiar (I wasn’t), human factors engineering is about accepting the fact that humans will inevitably make mistakes, and designing environments and tools that take that inevitability into account, so that the impact of mistakes is significantly decreased. Human factors engineering often goes hand-in-hand with extensive usability testing.

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This is Your Brain on Transformation

Sep 27, 2012, 10:45 AM, Posted by Mike Painter

Mike Painter Mike Painter

My recent journey to Mayo Clinic’s Transform 2012 began with a bike ride. I was up at 4:00 a.m. and drove for an hour to join hundreds of other cyclists in northern New Jersey for a 7:15 a.m. ride start. 107 miles and 7,600 feet of climbing later, I uploaded my ride stats to Strava, chatted some with colleagues, grabbed a bit of post-ride lunch, and blasted home. I made it to the Philadelphia airport just in time for my 7:00 p.m. flight. After a connection in Chicago, I arrived in Minneapolis around midnight, rented a car, and then drove 80 miles in the early morning hours across rural Minnesota, eventually arriving at my hotel in the town of Rochester.

Bright and early that morning at the meeting, feeling surprisingly bushy-tailed, I encountered a large gathering, almost like a mirage rising from the prairie, of curious, engaged people talking earnestly about how they were transforming American health care. But of course it wasn’t a mirage. It was real and impressive. Our national audacious effort to transform the health care colossus from its current state of dysfunction and inefficiency is impossibly complex and difficult. We know that. Nevertheless, my reaction to Transform 2012 was not simply because I found a large gathering focused on that health care transformation. No, the truly remarkable thing is that here was yet another of many large gatherings of engaged people working all over the United States to transform health care.

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